To evaluate the clinical effectiveness and economic impact of transcutaneous afferent patterned stimulation (TAPS) therapy in patients with Essential Tremor (ET).

TAPS^TM is a non-invasive, wrist-worn, frequency-calibrated, neurostimulation therapy (Cala Health, San Mateo, CA, USA). While previous clinical trials and post-market data analyses have demonstrated the efficacy and safety of TAPS [Pahwa 2019; Isaacson 2020; Lu 2023; Dai 2023], the impact of TAPS on healthcare resource utilization (HCRU) and costs has not been evaluated.

Patients with ET were enrolled in a 12-month pragmatic TAPS trial and propensity score-matched 1:2 to control patients not receiving TAPS in the Aetna claims database. ET-related HCRU and healthcare costs were compared between the TAPS and control arms. Clinical outcomes were also assessed within the TAPS arm, including the change in tremor power and Bain and Findley activities of daily living (BF-ADL) scores from baseline to 3, 6, 9, and 12-months follow-up.

The final matched cohort included 459 patients averaging 67 years of age, with 32% female. TAPS patients had significantly lower average annual ET-related healthcare costs ($680 vs. $1,140, p=0.0009; N = 153 TAPS vs. N = 306 controls) and demonstrated significant reductions in tremor power (50% to 67.7%, p<0.001) and BF-ADL scores (1.4 to 1.9 points, p<0.003) across all time points. Compared with baseline, TAPS patients also showed reductions in ET-related HCRU, including fewer ambulatory and office visits (0.3 visits, p<0.05), and decrease in average ET-related healthcare costs ($425, p=0.0007) in 12-month follow-up.

TAPS therapy offers substantial benefits for patients with ET in reducing ET-related HCRU and healthcare costs and improving clinical outcomes.